| NPI | 1578602587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OR MD153675) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM 2006-0229) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-07-02 |